血清前降钙素及C反应蛋白水平对急性胰腺炎预后的影响

Influence of procalcitonin and C-reactive protein on the prognosis of acute pancreatitis

目的探讨血清前降钙素(PCT)、C反应蛋白(CRP)在急性胰腺炎(AP)中的水平变化,分析PCT、CRP在鉴别AP的分型及对预后判断的应用价值。方法选择2006年9月至2010年12月期间入住右江民族医学院附属医院的急性胰腺炎患者60例,按RANSON诊断标准及Balthazar CT分级评分来判断轻症急性胰腺炎(MAP)和重症急性胰腺炎(SAP)的分组,每组30例。入选病例均于入院当天及入院后第35、、7、9天空腹静脉采血4 ml,提取血清后放置-80℃超低温冰箱保存备检。PCT采用双抗体夹心免疫发光法检测。结果 MAP组与SAP组PCT及CRP之间比较差异均有统计学意义(P<0.05),PCT水平高低与胰腺炎的严重程度、分型及预后判断密切相关,24 h内即能达到峰值,其敏感性、特异性均优于CRP,有显著性差异(P<0.05)。结论PCT是一种特异敏感的鉴别急性胰腺炎分型、判断疾病严重程度及预后的新指标,且检测方法简单易行、无创,患者及家属易于接受,值得临床试行推广。

Objective To explore the changes of serum procalcitonin （PCT） and C - reactive protein （CRP） in patients with acute pancreatitis, and analyze their value in the determination of the classification and prognosis of acute pancreatitis. Methods Sixty patients with acute pancreatitis hospitalized in the affiliated hospital of Youjiang medical college for nationalities from September 2006 to December 2010 were included in this study. The patients were grouped into mild AP （ MAP, 30 cases） and severe AP （ SAP, 30 cases） according to RANSON diagnostic criteria and Balthazar CT classification. Fasting venous blood was obtained from each patient on day 0, 3,5, 7, and 9 after hospitalization and serum sam- pies were then stored in - 800C. A sandwich luminescent immunoassay technique was used to detect PCT. Results There were significant differences in PCT and CRP levels between MAP group and SAP group （ P 〈 0.05 ）, PCT level was positively related to the severity of pancreatitis, classification and prognosis and reached peak level within 24 hours after the onset of disease. The sensitivity and specificity of PCT detection in this study were superior to CRP （ P 〈 0.05 ）. Conclusion PCT is a new specific and sensitive biomarker for the determination of disease severity, classification and prognosis in acute pancreatitis and its detection is simple, noninvasive and easy to be accepted by patient.